Effect of modified Henry approach with pronator quadratus preservation fixation on surgical outcome and long term prognosis of patients with distal radius fractures

doi:10.3877/cma.j.issn.2096-0263.2025.02.006

Abstract

Abstract:

Objective

To evaluate the therapeutic value of modified Henry approach for the treatment of distal radius fractures and to analyze the long-term prognosis of patients.

Methods

A total of 100 patients with distal radius fracture admitted to our hospital from February 2021 to February 2023 were retrospectively selected and divided into control group and improved group with 50 cases in each group according to different surgical methods.The control group underwent conventional Henry approach internal fixation， and the improved group underwent modified Henry approach to preserve anterior rotation intramural fixation.The clinical effect，operation time，blood loss and fracture exposure time of the two groups were compared.Serum malondialdehyde（MDA），superoxide dismutase（SOD）and C-reactive protein（CRP）levels were detected before surgery and 3 months after surgery.Visual analogue pain scale（VAS）and Cooney wrist joint score were performed before surgery and 3 and 6 months after surgery.Wrist flexion，dorsal extension and forearm rotation were compared between the two groups before surgery and 6 and 12 months after surgery.Radius height was recorded 1d and 12 months after surgery，radius loss height was calculated，and complications were analyzed.

Results

100 patients were successfully followed up for 12 months. The excellent and good rate of the improved group（96.00%）was higher than that of the control group（82.00%）（P＜0.05）.The blood loss in the improved group was lower than that in the control group，and the operation time and fracture exposure time were shorter than that in the control group（P＜0.05）.The levels of MDA and CRP were lower and the levels of SOD were higher in the two groups 3 months after operation，and MDA and CRP were lower and SOD were higher in the improved group than in the control group （P＜0.05）. VAS score of 3 and 6 months after surgery was lower in 2 groups than before surgery，Cooney score was higher than before surgery，and VAS score of 3 and 6 months after surgery in the improved group was lower than that in the control group，Cooney score was higher than that in the control group（P＜0.05）.Wrist flexion，dorsal extension and forearm rotation were higher in 2 groups 6 and 12 months after surgery than before surgery，and the improved group was higher than the control group（P＜0.05）.The height of radius loss in the improved group was lower than that in the control group（P＜0.05）.There was no difference in complication rate between 2 groups.

Conclusion

The modified Henry approach can improve the short-term efficacy of patients with distal radius fractures，shorten the operation and fracture exposure time，reduce the amount of blood loss，reduce postoperative inflammation and stress response，further improve the long-term wrist range of motion，reduce the height of radius loss，and have high safety.

Key words: Improved Henry approach, Fracture of distal radius, Inflammation, Radius height, Long term prognosis

Zheng Li, Yonggang Lu, Yiting Yang, Shengbo Nie, Minjie Liu, Yong Yang, Xiaojuan Ji, Jian Fan. Effect of modified Henry approach with pronator quadratus preservation fixation on surgical outcome and long term prognosis of patients with distal radius fractures[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2025, 11(02): 117-122.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlngkykfdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-0263.2025.02.006

https://zhlngkykfdzzz.cma-cmc.com.cn/EN/Y2025/V11/I02/117

Figures/Tables 8

组别	例数	性别（例）		年龄（岁， $\overset{ˉ}{x}$ ±s）	骨折原因（例）			AO分型（例）					骨折侧（例）
组别	例数	男	女	年龄（岁， $\overset{ˉ}{x}$ ±s）	摔倒伤	车祸伤	坠落伤	B1	B2	B3	C1	C2	左侧	右侧
改良组	50	22	28	55.29±13.65	33	7	10	19	16	10	3	2	27	23
对照组	50	20	30	54.07±12.92	35	8	7	20	15	9	3	3	24	26
χ ²/t 值		0.164		0.459		0.655				0.311			0.360
P 值		0.685		0.647		0.721				0.989			0.548

组别	例数	性别（例）		年龄（岁， $\overset{ˉ}{x}$ ±s）	骨折原因（例）			AO分型（例）					骨折侧（例）
组别	例数	男	女	年龄（岁， $\overset{ˉ}{x}$ ±s）	摔倒伤	车祸伤	坠落伤	B1	B2	B3	C1	C2	左侧	右侧
改良组	50	22	28	55.29±13.65	33	7	10	19	16	10	3	2	27	23
对照组	50	20	30	54.07±12.92	35	8	7	20	15	9	3	3	24	26
χ ²/t 值		0.164		0.459		0.655				0.311			0.360
P 值		0.685		0.647		0.721				0.989			0.548

组别	例数	优	良	差	优良率
改良组	50	32（64.00）	16（32.00）	2（4.00）	48（96.00）
对照组	50	27（54.00）	14（28.00）	9（18.00）	41（82.00）
χ ²值					5.005
P 值					0.025

组别	例数	手术时间（min）	出血量（mL）	骨折暴露时间（min）
改良组	50	62.24±7.53	28.95±4.68	13.96±2.01
对照组	50	71.29±5.87	37.51±7.54	22.79±3.89
t 值		6.702	6.821	14.260
P 值		＜0.001	＜0.001	＜0.001

组别	例数	MDA（U/L）		SOD（mg/L）		CRP（mg/L）
组别	例数	术前	术后3 个月	术前	术后3 个月	术前	术后3 个月
改良组	50	33.41±2.01	18.52±2.45^ac	11.63±3.44	22.69±2.63^ac	8.13±1.10	2.03±0.82^ac
对照组	50	32.99±3.47	23.21±4.30^a	12.14±2.78	18.40±3.02^a	8.01±2.43	3.67±0.71^a
t 值		0.741	6.701	0.815	7.575	0.318	10.691
P 值		0.461	＜0.001	0.417	＜0.001	0.751	＜0.001

组别	例数	VAS评分			Cooney评分
组别	例数	术前	术后3 个月	术后6个月	术前	术后3 个月	术后6个月
改良组	50	7.70±1.14	3.17±0.73^ac	1.25±0.52^abc	53.23±6.54	84.13±7.42^ac	91.21±3.68^abc
对照组	50	7.35±1.52	4.05±0.81^a	2.27±0.48^ab	51.29±5.05	78.56±5.79^a	85.31±4.06^ab
F 时间，P 时间			980.900，＜0.001			172.521，＜0.001
F 组间，P 组间			22.670，＜0.001			48.110，＜0.001
F 交互，P 交互			16.080，＜0.001			3.875，0.022

组别	例数	屈曲			前臂旋转
组别	例数	术前	术后6 个月	术后12 个月	术前	术后6 个月	术后12 个月
改良组	50	22.13±1.05	58.32±2.14^ac	70.24±2.45^abc	48.54±4.35	85.24±7.14^ac	92.02±8.69^abc
对照组	50	22.06±1.46	51.24±3.09^a	65.41±3.69^ab	47.63±6.11	80.10±8.46^a	86.46±8.91^ab
F 时间，P 时间			300.410，＜0.001			101.500，＜0.001
F 时间，P 时间			194.000，＜0.001			84.215，＜0.001
F 交互，P 交互			51.960，＜0.001			32.671，＜0.001
组别	例数	背伸
组别	例数	术前	术后6 个月	术后12 个月
改良组	50	22.01±1.87	40.12±2.26^ac	48.21±2.07^abc
对照组	50	22.20±1.99	35.51±2.68^a	41.45±2.41^ab
F 时间，P 时间			532.210，＜0.001
F 时间，P 时间			209.400，＜0.001
F 交互，P 交互			63.640，＜0.001

组别	例数	术后1 d	术后12 个月	桡骨丢失高度
改良组	50	12.35±1.34	12.19±1.04	0.16±0.04
对照组	50	12.31±1.27	11.99±0.92	0.32±0.09
t 值		0.153	1.536	11.487
P 值		0.879	0.128	＜0.001

References 16

1	Curtis DM， Lee CS， Boyajian HH， et al. Effect of global fracture care billing on distal radius fractures ［J］. Orthopedics， 2020， 43（5）：e471-e475.
2	Malik H，Appelboam A， Nunns M. Ultrasound-directed reduction of distal radius fractures in adults： a systematic review ［J］. Emerg Med J，2021，38（7）：537-542.
3	Dashe J， Murray B， Tornetta P， et al. Henry Versus Thompson Approach for Fixation of Proximal Third Radial Shaft Fractures：A Multicenter Study［J］.J Orthop Trauma，2020，34（2）：108-112.
4	李彦宇，赵岩，李孟杰.改良Henry 入路治疗不稳定桡骨远端骨折疗效分析［J］.中国骨与关节杂志，2020，9（9）：654-660.
5	赵星，刘鹏，徐圣康，等.单一掌侧横切口入路与改良Henry入路在锁定钢板固定治疗桡骨远端骨折中的疗效比较［J］.中华创伤骨科杂志，2024，26（02）：171-175.
6	Boonstra AM，Schiphorst Preuper HR，Balk GA，et al.Cut-off points for mild， moderate， and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain ［J］. Pain， 2014，155（12）：2545-2550.
7	杨顺，程亚博.腕关节镜辅助下治疗桡骨远端骨折的疗效观察［J］.中华手外科杂志，2020，36（02）：131-133.
8	Meek R， Sundaralingam A， Shen M， et al. Functional outcome and management pathways for adult patients presenting to an Australian health service with distal radius fracture ［J］. Emerg Med Australas，2020，32（1）：105-111.
9	柳晓林，叶晖，施进兴.保留旋前方肌掌侧接骨板内固定治疗成人桡骨远端不稳定骨折［J］. 中国修复重建外科杂志， 2020， 34（7）：814-819.
10	胡海洋，巨积辉，周正虎，等.经掌侧入路部分保留旋前方肌锁定接骨板治疗桡骨远端不稳定性骨折［J］. 中华手外科杂志， 2018， 34（3）：181-184.
11	许晓辉，吴文侠，李建林，等.术后抗感染护理对复杂性桡骨远端骨折老年患者血清炎性因子的影响［J］.河北医药，2020，42（4）：631-634.
12	Chisalita SI， Chong LT， Wajda M， et al. Association of Insulin-like Growth Factor-1， Bone Mass and Inflammation to Low-energy Distal Radius Fractures and Fracture Healing in Elderly Women Attending Emergency Care［J］.Orthop Surg，2017，9（4）：380-385.
13	Rolland T， Boutroy S， Vilayphiou N， et al. Poor trabecular microarchitecture at the distal radius in older men with increased concentration of high-sensitivity C-reactive protein--the STRAMBO study［J］.Calcif Tissue Int，2012，90（6）：496-506.
14	黄晓夏，贾麒钰，伊尔夏提·克力木，等.保留旋前方肌完整性联合掌侧锁定钢板内固定治疗桡骨远端骨折［J］.中国组织工程研究，2023，27（31）：4959-4964.
15	应晓洲，陈昭心，陈辉，等.保留旋前方肌改良Henry入路掌侧钢板内固定治疗老年桡骨远端骨折［J］. 中华创伤杂志， 2020， 36（06）：514-519.
16	朱宗东，廖锋，魏丹，等.充填植骨并部分保留旋前方肌掌侧锁定钢板内固定治疗桡骨远端C3.1、C3.2 型骨折［J］. 中华手外科杂志，2022，38（3）：214-217.

[1]	Yiran Gong, Wenting Li, Yabin Fang, Kaiyi Yang, Juxin He, Shuqiang Chen. Clinical value of ultrasonographic assessment of extensor tendon enthesitis of distal interphalangeal joints in patients with inflammatory arthritis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(04): 408-413.
[2]	Chun Yi, Dongsheng Yuan, Xuejun Xiong. Relationship of systemic immune-inflammation index with decreased bone mass density and osteoporosis [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(05): 609-617.
[3]	Zheng Li, Jinfeng Ma. Construction of a nomogram model for predicting prognosis of esophagogastric junction adenocarcinoma patients after radical surgery based on inflammatory response scoring system [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(02): 170-175.
[4]	Jie Zhang, Xiaoxia Luo, Hong Yu. Predictive value of systemic immune inflammation index in patients with acute pancreatitis complicated with organ function impairment [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 68-71.
[5]	Mei Tang, Li Zhou, Cenyue Niu, Xiaotong Zhou, Qian Wang. Clinical significance of ICG fluorescence guided laparoscopic hepatectomy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 655-658.
[6]	Xiaolong Zong, Yuanxi Lin, Tianyi Zhang, Yaru Liu, Duanyang Li, Zhenyu Li. Pterostilbene attenuates acute lung injury in septic mice by inhibiting inflammatory responses and NETs formation [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(01): 29-35.
[7]	Yuchao Zhang, Qingqing Gao, Yang Yang, Dawei Ran, Yunhai Zhou, Mingzhi Pu. Clinical effect analysis of Qingfei Huatan Zhuyu Decoction，a Traditional Chinese Medicine，in treating patients with AECOPD [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(01): 36-41.
[8]	Lu Sun, Yaling Jiang, Lingjun Chen. Effect of butorphanol on neuroinflammation and JAK2/STAT3 signaling pathway in rats with cerebral ischemia-reperfusion injury [J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2024, 14(06): 344-350.
[9]	Qingli Cai, Xiaoyue Wang, Kehong Chen, Fang Yu. Inhibition of histone lactylation attenuated peritoneal in flamm ation induced by high-glucose peritoneal dialysate [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2025, 14(01): 34-43.
[10]	Xia Du, Mengqing Ma, Changchun Cao. Research progress on the pathogenesis and intervention targets of contrast-induced acute kidney injury [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(05): 279-282.
[11]	Jingting Sun, Na Li, Minghui Luo, Yaoyao Gao, Yihang Bai, Guozhen Zhu. Effect and mechanism of short-chain fatty acids on inflammation and fibrosis of mice with renal ischemia-reperfusion injury [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(04): 181-187.
[12]	Xiaoqing Zhang, Wen Tang. Research advance in the role of predicting the prognosis of peritoneal dialysis patients by recalculated biomarkers based on clinical laboratory indicators [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(04): 213-218.
[13]	Li Hang, Yaohui Zhang, Wenkai Sun. Effect of Shenba Kangliu Liquid on intestinal function, inflammatory index and recurrence after colorectal adenomatous polyp surgery [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(05): 413-416.
[14]	Shan Shi, Zhigang Xu, Shuang Wei, Hao Guan, Jihong Shi. Advances in understanding of role of wound pathogens in wound healing and scar formation [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(10): 955-960.
[15]	Wanrui Shi, Ligang Cui. Advances in imaging diagnosis of transient perivascular inflammation of the carotid artery [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(05): 516-519.

Please choose a citation manager

Content to export